Suppose a patient is going into kidney failure, has high cholesterol and their blood pressure is consistently high. However, they refuse blood pressure medication and statin treatment, both recommended for preventing worsening of the kidney failure. For your liability, it is very important to document a conversation about how you are trying to save their kidney and their refusal to comply. My insurance also says an "Informed Refusal AMA" is good for them to sign, listing the bad outcome of their choices and the medical recommendations they are refusing. But, when it comes time to signing these things, I start to wonder what the point is of continuing care.
